Sajid Javid’s Conservative Party Conference Speech

Sajid Javid has been hitting the headlines this week as he holds out on introducing Plan B to tackle the spiking Covid-cases.

Ed Clements, in Freshwater’s specialist healthcare team, takes a look at his recent speech delivered at the Conservative Party Conference to see if there are any clues as to where the secretary for health and social care is heading in terms of future policy decisions.

Following on from the prime minister’s much beloved and oft-repeated three-word slogans, Sajid Javid, the secretary for health and social care, began his speech at the Conservative Party Conference with his very own formulation of the genre: Covid, Recovery, Reform.

Covid

Interestingly, Mr Javid spoke only very fleetingly on the subject that has dominated our lives for much of the past two years. Insisting, as he often does, that he is not the “covid secretary” but the secretary for health and social care. Mr Javid appears to be very much looking forward, seemingly hoping that the worst of the Covid-19 crisis is very much behind us. But with calls for Plan B to be urgently adopted, a winter crisis looming, and the possibility of a new variant taking hold, only time will tell if this is the right approach.

Recovery

Particularly notable in Mr Javid’s speech was his reference to individual responsibility. “Health and social care,” explained the health secretary, “begins at home. Family first, then community, then the state.” The implication, of course, being that people need to take ownership of their own health and wellbeing, which could ultimately help alleviate some pressure on the NHS. Given that one of the most pressing issues to arise out of the pandemic was missed cancer screenings, it is perhaps surprising that Mr Javid would choose this moment to encourage people to use the NHS only after other options have been exhausted. Quite how the “family” or “community” will be able to solve the cancer screening backlog remains to be seen.

And, of course, as population health strategies highlight, good health at home requires good housing, good jobs, safe and vibrant communities, good educational and training opportunities and suitable transport connections. Effective and accessible mental health services are also essential. Consequently, given that the role of the “state” is fundamental to the quality and delivery of these areas of health and wellbeing, Mr Javid’s attempt to underplay its importance seems fairly misguided.

Reform: Innovation and leadership

The most substantive policy proposal the health secretary alerted us to (though “levelling up” was, of course, mentioned but, as of yet, still undefined) was that of a wide-ranging leadership review. Retired military chief, Sir Gordon Messenger, will lead the review, which Mr Javid explained, “…will shine a light on the outstanding leaders in health and social care to drive efficiency and innovation.”

While many critics argue that the essential issue facing the NHS is a lack of funding, this review suggests that Mr Javid sees things differently. Mr Javid would surely argue that the financial problem will be tackled by next year’s National Insurance hike, which aims to raise around £34 billion a year. Firmly in Mr Javid’s sights, however, is clearly the issue of leadership and improving efficiency. In this vein, Mr Javid aims to set up an “NHS delivery unit” to facilitate an efficiency drive. Little information exists right now that gives any detail with regards to the precise nature and purpose of the delivery unit, but waiting lists are sure to be at the top of the agenda. Hopefully, he will focus on growing more good leadership rather than hammering the exhausted pool of leaders, who have just brought the NHS through the most demanding period in its history.

An NHS for the future?

The health and social care secretary made clear in his speech that waiting lists will “get worse before they get better”, having explained previously the figures could reach 13 million. NHS waiting lists are an obvious point of attack for the Labour party, so Mr Javid will be under enormous pressure to get the situation under control. With patients seemingly losing sympathy for the pandemic being used as an excuse for the lack of face-to-face care, as well as the fact that higher taxes meaning people will soon be paying more for a service described by some as in decline, Mr Javid’s review will need to be extensive and proceeding reforms will likely be of a significant magnitude.

Finally, conspicuous by its absence, albeit altogether unsurprising given its routine omission from the overall healthcare debate, is the lack of attention given to social care. Mr Javid is after all, secretary of state for health AND social care, but it didn’t get much of a look in in his speech. But with the future of social care looking increasingly precarious, and with a shortage of staff crippling the system, necessary reforms seem at a worrying distance.

Having ‘just’ survived one of the most severe threats since its creation, the NHS is likely to undergo one of the most transformative phases of its existence. The next few months and years offer little respite for the NHS, rather the challenges it faces will be as equally threatening. Consequently, Mr Javid’s reforms will need to address issues quickly with the public and media primed to scrutinise the path forward.